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Remarks from the Honourable Jane Philpott, Minister of Health to the Canadian Cardiovascular Congress

Speech

October 24, 2016 Montreal, QC

Check against delivery. This speech has been translated in accordance with the Government of Canada's official languages policy and edited for posting and distribution in accordance with its communications policy.

Thank you very much. Hello everyone and thank you for the welcome. I am thrilled to be here this morning in Quebec, in the beautiful city of Montréal. We could not have had a better place for our announcement today. As you know, Montréal is a world gastronomic capital and I want to talk primarily about food today. So what better than to be here in Montréal at the Canadian Cardiovascular Congress, surrounded by experts in healthy lifestyles.

With my family and friends I think the best gatherings always involve food. You know how it is when you get together. People love to gather in the kitchen. It’s a place for sharing, a place for vigorous debate, sometimes even arguments, a place where we feed both our bodies and our minds. In my home no matter how busy the day is, whoever happens to be there we still try to gather around the dinner table each day. Miraculously everyone sets their phones aside and we actually talk to one another around the table as we eat.

When I think back further to my childhood I remember the dinner table was actually quite different. It was always my mom who cooked. My dad could make tomato soup but that was the extent of his skills in the kitchen. We had meat, potatoes and a vegetable, sometimes two vegetables. We had for dessert a variety of things but my favourite memory is my mom’s fabulous apple pie.

In the 1960’s and 1970’s in our home a multicultural meal was spaghetti. We’ve never heard of sushi let alone malai kofta or pad thai. Then later in life in the 1990’s I lived for a decade in Niger, West Africa. In Niger I gained a whole new perspective on food. I enjoyed new foods like Kuli-kuli, Shinkafa Da Wake, Tuwo da miya, which is pounded millet. I lived in a country where it was not uncommon for people to go for a full day on a meal and sometimes no meal at all. I also learned a great deal of respect for food preparation. I walked to the market that was held once a week in our village. I bought my meat and vegetables from the butcher and the salespeople in the open market on Wednesday mornings. I made almost all of our food from scratch, whether it was bread or lasagna noodles, homemade yoghurt, homemade cottage cheese but my life has changed a lot since then. Now I rarely do the grocery shopping. My husband does almost all the shopping and cooking in our home and that’s a good thing because he’s a much better cook than I.

I often eat on the run. I’m like many of you. We struggle to find the time in our busy schedules to eat with family and friends around the dinner table. I don’t want to entirely romanticize the way things were. I believe Canada has never been better or stronger than it is today and I actually never want to go back to my childhood version of meat and potatoes as standard everyday fare. But we have much more interesting food choices now and many other changes have come. In this world where many, in fact millions, still go hungry, most of us here in Canada have access to a seemingly endless supply of relatively inexpensive, attractive, convenient, tasty, supersized, high calorie ultra-processed food. Canadians are faced with a constant flow of changing and conflicting messages creating a lot of clutter and confusion about what we should eat and what we shouldn’t. Sometimes we struggle to use the nutritional information that’s available to us. We want simplified messages and information to help us make healthier food choices.

I don’t need to tell this particular audience that these past decades have also brought a range of medical concerns that are related to the way we eat. Rates of obesity, hypertension, diabetes and other chronic diseases are rising and no doubt they’ve been the very matters you’ve been discussing over the past two or three days. There’s a very real fear that the next generation of Canadian kids will be the first that could be less healthy than their parents. The current state of our food environment is of our collective making, which means we are going to have to work together collectively to improve it. I want to say that I understand the path to healthy food ecosystem in Canada requires a whole of society response. It has to take into account sustainable agriculture, food security, the cost of food, how food is distributed, where it’s sold, how it’s prepared and so much more.

It’s within that very broad range of stakeholders that governments have an important role. Today I’m going to be focusing specifically on the role of Health Canada, although I recognize that many other departments of our own government are also involved. How can my department help Canadians to make more healthy choices? How can we make that easier for Canadians and their families?

One good place to start is actually the most popular document produced by my department, Health Canada and it’s also a document that’s the subject of vigorous debate among experts. You’ll probably guess that’s Canada’s Food Guide. It’s iconic. Almost every Canadian has studied it in school and we can conjure up images of past food guides in our minds. As a family doctor, I used to keep a stack of Canada’s food guides in my desk to hand out to families who came in for their periodic health review.

Last year my department completed a review of the evidence around the food guide both in terms of the dietary guidance it includes and how it’s being used by healthcare professionals like yourselves, educators and others. The evidence found that Canadians are not always making healthy food choices. It might not be a surprise to you that we aren’t eating enough vegetables, fruits or whole grains. About 30% of the calories we consume and sometimes more come from foods that are high in fats, sugar and sodium. We aren’t eating other nutrients such as calcium and fibre as much as we should.

We also found that Canada’s Food Guide is not meeting the needs of all audiences. While most Canadians are aware of the guide, they find it hard to interpret. They find it hard to apply the advice in it to their daily lives. The classic one size fits all food guide no longer meets the needs of Canadians. Canadians need a new tool, a tool they can adapt to meet their own unique needs and their dietary restrictions, a resource they can take with them on the go to help them make healthier choices whether they’re in the grocery store or in a restaurant. Around the world and I’ve discussed this with my counterparts the Ministers of Health from other countries, I’ve seen some wonderful creative food guides that seem much more helpful than the one we’ve currently been using.

Today I’m proud to announce that we are officially beginning the process to update Canada’s food guide to transform it into a whole suite of products that will provide Canadians with the most up to date advice on eating well. I have many views on how it could be more helpful. Clearly, I think it needs to be evidence informed. It has to be relevant to our lives and it has to be practical. It needs to be in plain language, easy to understand, easy to remember and follow. It needs to have simple messages people can get at a glance; things like less saturated fats, more fibre; less meat, more veggies; less processed food. Get more physically active. I think you can imagine as well as I can many possible applications.

In a world where our entire lives are controlled by our smart phones, the food guide needs to be adaptable into health apps that will allow people to individualize the advice on the Canada food guide. We should be able to input data about ourselves, the fact that I’m this high and this wide, the fact that I have a food preference, that I have a food sensitivity, that I have a food allergy. All of these need to be able to be introduced and applied to a food guide that works for each of us. Individual risk factors can also be included in the food guide and that’s an area on which many of you would have important input.

I need to know what Canadians think about this. Our first step is listening to Canadians to better understand their needs and their great ideas, as decision makers for themselves and their families, as food experts and as healthcare professionals. For the next forty-five days we will be consulting on the great idea about the food guide.

But our workplace at Health Canada this year involves much more than updating the food guide. As I’ve said already Health Canada is one of a number of stakeholders but as one of the regulators for food we have a responsibility to raise awareness for Canadians about food. We have a responsibility to nudge people towards good decisions about food and to make sure we support informed choices and mindful eating. By the end of the year we will be finalizing a new Nutrition Facts Table that will be based on science and will better meet the needs of Canadians and their families.

On that table, there will be standardized serving sizes to make it easier for Canadians trying to compare the nutritional value of products. You all know how complicated it can be when you’re standing in the grocery store trying to compare two products based on different serving sizes.

There will be more information on sugar in a more helpful way. For example, the public is going to be able to get a clearer idea about the amount of sugar directly from the label. It won’t be hidden on a list that includes things like corn syrup, molasses, sucrose and dozens of other aliases that are used for sugar. These are now going to be grouped together under sugar, with the total number of grams provided.

We’re going to require that food colours need to be called by their common names. We need to make sure ingredients are easier to read including important allergen information that is vital to protecting the growing number of Canadians with food allergies.

We’re also going to begin a process that I think is going to be exceptionally helpful when you’re shopping for food. We’re going to develop a simple way to put health information on sodium, sugars and saturated fats on the front of the food package. Just imagine walking down the grocery store aisle and spotting at a glance which products are high in sugars, salt and saturated fats using noticeable symbols that are easy to understand. It will be much easier to make smart, healthy choices.

My goal is to propose front-of-package labeling regulations in 2017. In the next few weeks we’re also going to begin a regulatory process to eliminate industrially produced transfats from our restaurants and grocery stores. Those changes will be finalized in 2018. In addition we’re going to step up our game on sodium.

You may already know that in 2012 Canada published sodium reduction targets for the food industry that needed to be met by 2016. That time has nearly arrived and, at the end of 2016, you can look forward to an announcement about how well various food groups have done on the reduction of sodium. Earlier this month Health Canada hosted a national symposium with stakeholders and experts to discuss the progress, their plans for future monitoring and evaluation and their opportunities to further reduce sodium in processed and restaurant foods.

That interim report with the monitoring results and outcomes from the workshop is going to be published online by the end of this year and full information on all the results of our sodium monitoring are going to be made public in 2017.

The last component on healthy eating I wanted to discuss today is the important issue of marketing, marketing unhealthy foods and beverages to kids. I’m proud to say that we campaigned on this in the last election and now we’re delivering on our commitment to make sure that we help children live healthier lives by protecting them from marketing of unhealthy products. I also want to note the work of Senator Nancy Greene Raine in this regard. You may be aware she recently introduced a bill in the Senate proposing the prohibition of the marketing of all food and beverages to children under thirteen.

Some will argue that it’s difficult to define the difference between unhealthy and healthy food and beverages but I think we can all agree that unhealthy foods and beverages are those that are energy dense, nutrient poor and high in saturated fats, trans fats, sugar and salt. Restricting the marketing of these products to kids is the right thing to do. Children’s minds are particularly vulnerable and like all of us they are swayed by advertising. We want them to learn about healthy food choices in their early years as they are establishing their eating habits and not to be unduly influenced to choose products that lack food value.

In Quebec the Consumer Protection Act prohibits any advertising aimed at children under the age of 13. A recent study by the University of British Columbia revealed that that prohibition resulted in a decrease in the consumption of fast foods.

It is true that the legal and regulatory environment of marketing to children is complex, but that complexity must not be used as an excuse for inaction. We must protect society and our youth. We know that there is a series of actions that could limit marketing that targets youth. We are currently analyzing the various approaches and options.

As we move forward with this particular mandate item it’s going to be important for the government to understand what parents want for their kids and how we can work with other stakeholders to restrict marketing and use effective methods that are going to stand the test of time. Through these initiatives we will strive for both meaningful engagement with the public and openness and transparency about all meetings with stakeholders.

To maintain Canadians’ trust we are going to share information about stakeholder meetings as well as correspondence sent to Health Canada outside of a formal consultation process. These are significant changes that we are approaching but they are only the beginning. The quest for healthy eating is a moving target. Knowledge is evolving all the time. We must continue to pay attention to developments both in Canada and internationally and ensure that we are on the cutting edge.

It takes much more than just healthy eating to keep Canadians healthy and so I want to mention today that, in fact, our Healthy Canada Strategy in Health Canada includes three pillars. You’ve heard me speak today primarily about healthy eating, but I would like to briefly touch on two other pillars which are no less important and need to be taken into consideration alongside.

The second pillar focuses on healthy living. How do we conduct our day to day activities whether at home, at work or at play? How much physical activity do we get? How can we discourage Canadians from choosing or persisting with unhealthy lifestyle choices such as smoking? For example, as many of you know very well, smoking has declined, but some 37,000 Canadians continue to die annually from illnesses related to smoking and close to 30,000 young people still start smoking every year.

To address this I think the people in this room are happy to know that we plan to adopt stringent plain packaging regulations for tobacco products, to prohibit menthol in all types of tobacco products and to introduce regulations around vaping. I also want to touch on the importance of physical activity. The Public Health Agency of Canada which falls within my portfolio is working with multiple partners, private organizations and the NGO sector to deliver physical activity programs and initiatives.

This includes organizations like the Heart and Stroke Foundation that Mary is with, the Running Room, the Canadian Cancer Society, Reebok, the Canadian Football League, Participaction, RBC, Social Change Rewards and many other partners. Our collective efforts are designed to help people develop physical literacy, skills that allow an individual to engage in physical activity throughout their life and countless Canadian studies as you know indicate Canadians are increasingly sedentary.

The effort has been complemented by other government initiatives from encouraging green spaces as part of our climate change agenda or supporting community efforts that encourage people to walk, cycle and make other healthy lifestyle choices. This is an area that I believe is ripe for innovation in technology. I’d like to see us make better use of smart phone apps that encourage Canadians to take charge of their health and their level of physical activity. I’m impressed with the work of many Canadian researchers who are studying what works, what technologies can be used to help keep Canadians active.

It must also be said that I am inspired by people like Pierre Lavoie someone who I met this summer in Saguenay. He started the Grand Défi Pierre Lavoie to encourage youth to adopt healthy lifestyles. He created one of the best events for highlighting healthy lifestyles and that promotes healthy eating and perseverance at school.

The Grand Défi team works with schools in Quebec to help youth make healthy choices every day and develop skills that will become the standard for future generations. The team raises awareness among parents regarding the importance of healthy lifestyles for their children's health and for their own. Last weekend, the Grand Défi de Pierre Lavoie organized two big 5km walks on Saturday in Québec City and yesterday here in Montréal.

Finally I want to address something that’s both a personal and professional commitment. Our third pillar for the Healthy Canada platform is healthy minds. It should be abundantly clear to all of us that there is no health without mental health. Physical health and mental health are inseparable. This is something that has been underemphasized for far too long. I’m not sure how much it’s emphasized at this particular congress but I suspect it’s increasingly emphasized and rightly so. We need to link our efforts to treat mental health with our efforts to address physical health. One third of the people in this country over the course of their lives will experience mental illness.

I often like to say that no matter what statistics you use, mental illness affects us all, all of us either directly or indirectly. Unfortunately in Canada we tend to pay less attention to mental health. We allocate a lower percentage of our health spending to it than do most industrialized countries. The mental health issues we face are troubling. I suspect they’re well known to you – increasing rates of depression and anxiety, the tragedy every week of youth suicides in this country, post-traumatic stress injuries particularly among military personnel, veterans, first responders and healthcare providers. A shared commitment to mental health is needed to turn the tide. It means fighting stigma. It means providing better mental health services and it means building resilience in people and communities to prevent and treat mental illness and promote wellbeing.

Our government will not back down in the face of this challenge, but we cannot face it alone. If we want to see progress in mental health, we must build solid partnerships. We must identify effective programs, develop them and implement them so they can make our communities stronger and improve services. The provinces and territories will be essential key partners in our progress regarding mental health. That is why mental health is one of the issues that I emphasize every time we have the opportunity to discuss the future of health care in this country.

It’s also why we’re focused on supporting mental wellness in indigenous communities including the introduction of a national toll free 24/7 service the First Nations and Inuit Hope for Wellness help line which is providing culturally competent crisis intervention counseling for First Nations and Inuit. If you don’t already know about it, make sure you get the word out: 1-855-242-3310. You can go to my Twitter feed to get that phone number. Service is available, counseling in English, French, Cree, Ojibway and Inuktitut. That’s one of the initiatives we have taken. I am absolutely determined that we, as a nation, will bring mental illness out of the shadows.

We don’t know all of the answers but we know that we have to speak up. It reminds me of something Martin Luther King said when he talked about different social challenges that were being faced in his time. He said that some of us have already begun to break the silence and we have found that the calling to speak is a vocation of agony, but we must speak. I say to you together today we must speak with all the humility that is appropriate to our limited vision, but we must speak.

In conclusion I wanted to comment about Health Canada’s mission statement. As I was preparing this talk and thinking about our goals and the responsibilities of my department to keep Canadians healthy I went to the Health Canada website, something I don’t necessarily do every day. I thought I’d better check and make sure everything I’m saying fits with our mission statement.

I want to read to you what our mission statement says: “Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. Health Canada is committed to improving the lives of all Canada’s people and to making this country’s population among the healthiest in the world.”

Governments clearly have a role in creating the circumstances to support a healthy society.

I would also like to mention the announcement made yesterday by the Government of Quebec. The government launched its first health prevention policy and set specific targets to achieve by 2025 in order to make Quebec healthier. The proposed approach is based on a series of factors and proposes actions based on health determinants. I applaud that approach.

But the vision of making this country’s population among the healthiest in the world, and maybe we can aim higher – I think Canada has the means to be able to aim to be the healthiest country in the world – but it’s not something that governments can do alone. To start with improving people’s health involves addressing all of the socio-economic determinants of health.

From the point of view of today’s topic and from Health Canada’s perspective we do have an important role to play to support healthy eating, healthy living and healthy minds. But it’s also going to require you, all of you, healthcare professionals, researchers, educators and the industries associated with food, fitness and healthcare. Most importantly it’s going to require the engagement of all Canadians.

I trust the announcements we have made this morning are going to go a long way to helping Canadians who want to be informed and enabled to make the best possible decisions about their health. I’m looking forward to that day when I’m going to walk down a grocery store aisle and I’m going to see those front-of-package labels that are going to help me choose the very healthiest breakfast cereal on the shelf. I’m going to be armed with my updated Canada’s Food Guide, that is going to be easy to remember. It’s going to be personalized for my needs and my family’s needs and I’m going to remember this day when we took an important step together towards a healthier Canada.

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